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BILLING & COLLECTIONS

Medicare covering OTC COVID-19 tests

Starting this week and through the end of the COVID-19 public health emergency (PHE), Medicare covers and pays for over-the-counter (OTC) COVID-19 tests at no cost to people with Medicare Part B, including those with Medicare Advantage (MA) plans. In addition to helping prevent the spread of COVID-19, the goal is to find out if Medicare payment for OTC COVID-19 tests will improve access to testing and result in Medicare savings or other program improvements. What’s covered Eligible providers or suppliers can distribute U.S. FDA-approved, authorized, or cleared OTC COVID-19 tests to patients enrolled in Part B, including those enrolled in MA plans. Patients who only have Medicare Part A can get free OTC COVID-19 tests through other government-led programs, like covidtests.gov, which operates through the United States Postal Service (USPS). Or,… . . . read more.

GETTING PAID

Getting Medicare reimbursement for telehealth services: The new CONNECT for Health Act

Like most cliches, the one about the COVID-19 pandemic’s transformation of medicine forever is laden with truth. Telemedicine is Exhibit A. Of course, telemedicine goes back decades. But the pandemic accelerated the breakdown of resistance on the parts of providers, regulators and above all, patients. It was supposed to be just temporary. But to use still one more cliché, now that the toothpaste is out of the tube, it becomes a matter of figuring out how to regulate it effectively. Ironically, but hardly unexpectedly, one of Congress’ first attempts to impose systematic regulation involves recycling a piece of legislation that falabiled to gain support in pre-pandemic times but may make it into law this time. Here’s a quick overview of the so-called CONNECT for Health Act and what medical office… . . . read more.

Medicare

New deadline of Dec. 13 to update APM Incentive billing info

Is your office among the clinicians that need to verify Medicare billing information by Dec. 13 in order to receive payments? The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program website includes 2020 Alternative Payment Model (APM) Incentive Payment details. To access information on the incentive amount and organization paid, clinicians and surrogates can log in to the QPP website using their HARP credentials. Many eligible clinicians who were Qualifying APM Participants (QPs) based on their 2018 performance began receiving their 2020 5% APM Incentive Payments last month. If you have already received your payment, you do not need to do anything. CMS also posted a new 2020 APM Incentive Payment Fact Sheet to explain: Who is eligible to receive an APM incentive payment in 2020 How CMS determines your 2020 APM… . . . read more.

CMS ANNOUNCES NEW TERMS

You have more time to start COVID-19 Medicare loan repayments

The Centers for Medicare & Medicaid Services (CMS) has announced amended terms for payments issued under the Accelerated and Advance Payment (AAP) Program.  This Medicare loan program allows CMS to make advance payments to providers and are typically used in emergency situations.  Under the Continuing Appropriations Act, 2021 and Other Extensions Act repayment will now begin one year from the issuance date of each provider or supplier’s accelerated or advance payment.  CMS issued $106 billion in payments to providers and suppliers in order to alleviate the financial burden healthcare providers faced while experiencing cash flow issues in the early stages of combating the coronavirus disease 2019 (COVID-19) Public Health Emergency (PHE). “In the throes of an unprecedented pandemic, providers and suppliers on the frontlines needed a lifeline to help keep them… . . . read more.

BILLING & COLLECTIONS

Retaining patients as insurance landscape shifts

By Kerri Lenderman bio Walmart’s July announcement that they plan to start selling Medicare insurance should have resonated with America’s physicians as more than an interesting headline to interrupt a summer of coronavirus news.  Indeed, it should be a wakeup call and a reminder that unsettling and unconventional forces with deep pockets and consumer brand loyalty are forming a tsunami of disruption in how insurance will be marketed and influenced for years to come. Competition for Medicare market share has always been steep.  Historically it manifested in the form of aggressive health plan marketing campaigns from insurers and brokers, all trying to lock in Medicare eligibles – especially people approaching age 65.  Selecting a plan is overwhelming with dozens of plan options to choose from in a given market, including… . . . read more.

CMS UPDATES

Tell your patients about the new eMedicare app launched this year

Today, the Centers for Medicare & Medicaid Services (CMS) launched a new app that gives consumers a modernized Medicare experience with direct access on a mobile device to…


. . . read more

MIPS

You have less than one month to submit MIPS Year 2 (2018) Data for the Quality Payment Program

The Centers for Medicare & Medicaid Services (CMS) has officially opened the data submission period for…


. . . read more

TELEHEALTH

CY 2019 List of Medicare Telehealth Services

Why you need this tool:

Has your practice recently implemented telehealth? If so, you might not know which CPT codes are available for reimbursement.


. . . download here

MULTIPLE INSURANCE COVERAGES

How to determine the order of multiple insurance coverages

By Ranadene (Randi) K. Tapio, MBA, CMRS, CMC, Guest Contributor  bio
When patients have multiple insurance coverage, at times it can be difficult to determine which one is primary, secondary, and tertiary. Sometimes, the patients don’t even know…


. . . read more

2019 PHYSICIAN FEE SCHEDULE AND QPP

CMS finalizes changes to the Medicare Physician Fee Schedule and Quality Payment Program

Last week, the Centers for Medicare & Medicaid Services (CMS) finalized proposals that it says will address provider burnout and provide clinicians immediate relief from…


. . . read more


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